Trial reportJournal of clinical hypertension (Greenwich, Conn.)2019
Incidence, prevalence, and predictors of treatment-resistant hypertension with intensive blood pressure lowering.
Trial report in Journal of clinical hypertension (Greenwich, Conn.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed.
- Empagliflozin in resistant hypertension and heart failure with preserved ejection fraction: the EMPEROR-Preserved trial.European heart journal · 2025Trial
- Incidence, prevalence, and predictors of treatment-resistant hypertension with intensive blood pressure lowering.Journal of clinical hypertension (Greenwich, Conn.) · 2019Trial
- Contemporary Prevalence and Treatment Patterns Among US Adults With Apparent Treatment-Resistant Hypertension.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Incidence and prognosis of apparent-treatment resistant hypertension: a multi-state analysis using real world evidence.Clinical hypertension · 2026Article
- Advances in Hypertension Management: Insights from the Latest European Guidelines.Journal of cardiovascular development and disease · 2025Review
- Article
- Characterizing apparent treatment resistant hypertension in the United States: insights from the All of Us Research Program.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Prevalence, Clinical Characteristics, and Treatment of Patients with Resistant Hypertension: A Single-Center Study.Journal of cardiovascular development and disease · 2024Article
- Observational
- Social Determinants of Health and Incident Apparent Treatment-Resistant Hypertension Among White and Black US Adults: The REGARDS Study.Journal of the American Heart Association · 2024Article
- 2022 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension.Acta Cardiologica Sinica · 2022Article
- Spironolactone Reduces Aortic Stiffness in Patients With Resistant Hypertension Independent of Blood Pressure Change.Journal of the American Heart Association · 2021Article
- Effect of renal denervation on long-term outcomes in patients with resistant hypertension.Cardiovascular diabetology · 2021Review
- Underutilization of Treatment for Black Adults With Apparent Treatment-Resistant Hypertension: JHS and the REGARDS Study.Hypertension (Dallas, Tex. : 1979) · 2020Article
- Renal Denervation for Resistant Hypertension: Where Do We Stand?Current hypertension reports · 2020Review
- Redefining Resistant Hypertension: A Comparison of Cardiovascular Risk Associated With the 2018 Versus 2008 American Heart Association Definitions for Resistant Hypertension.Circulation. Cardiovascular quality and outcomes · 2020Article
- Resistant hypertension-defining the scope of the problem.Progress in cardiovascular diseasesReview
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Recent guidelines call for more intensive blood pressure (BP)-lowering and a less-stringent treatment-resistant hypertension (TRH) definition, both of which may increase the occurrence of this high-risk phenotype. We performed a post hoc analysis of 11 784 SPRINT and ACCORD-BP participants without baseline TRH, who were randomized to an intensive (<120 mm Hg) or standard (<140 mm Hg) systolic BP target. Incidence, prevalence, and predictors of TRH were compared using the updated definition (requiring ≥4 drugs to achieve BP < 130/80 mm Hg) during intensive treatment, vs the former definition (requiring ≥4 drugs to achieve BP < 140/90 mm Hg) during standard treatment. Incidence/prevalence of apparent refractory hypertension (RFH; uncontrolled BP despite ≥5 drugs) was similarly compared. Overall, 5702 and 6082 patients were included in the intensive and standard treatment cohorts, respectively. Crude TRH incidence using the updated definition under intensive treatment was 30.3 (95% CI, 29.3-31.4) per 100 patient-years, compared with 9.7 (95% CI, 9.2-10.2) using the prior definition under standard treatment. Point prevalence using the prior TRH definition at 1-year was 7.5% in SPRINT and 14% in ACCORD vs 22% and 36%, respectively, with the updated TRH definition. Significant predictors of incident TRH included number of baseline antihypertensive drugs, having diabetes, baseline systolic BP, and Black race. Incidence of apparent RFH was also significantly greater using the updated vs prior definition (4.5 vs 1.0 per 100 person-years). Implementation of the 2017 hypertension guideline, including lower BP goals for most individuals, is expected to substantially increase treatment burden and incident TRH among the hypertensive population.
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